Overactive and Underactive Let-Down

Mother holding baby in bed while father sleepsBreast milk let-down is a normal and necessary function in the process of lactation and breastfeeding. However, sometimes issues may arise that can cause concern for a new mother. One of these issues is an overactive, or underactive, let-down.

Overactive let-down is defined simply as milk that is flowing too fast.

The main reason for overactive let-down is a mother having an overabundant milk supply. Signs of an overabundant milk supply are frequently engorged breasts – despite feeding the baby as needed, leaking milk throughout the day, or the “spraying” of milk. Overactive let-down is most commonly experienced in the first two months of breastfeeding. It is also often an issue when the baby hits a growth spurt and is nursing more frequently, which in turns causes the breast to produce more milk.

When a mother is experiencing overactive let-down, her baby may have problems nursing. Some behaviors a nursing baby may exhibit when there is overactive let-down are: the baby may

  • gasp and choke, due to milk entering the mouth too fast,
  • pull away from the breast,
  • refuse the breast,
  • frequently spitting up,
  • be very gassy, and
  • gain weight very rapidly.

There are some things, however, that a mother with an overabundant milk supply can do to help make it easier for her baby to handle the milk flow and get the fattier part of the milk. The mother should find a posture that enables the baby's head to move freely to handle the flow of milk. (A suggested position is the mother in a reclining position with the baby's body supported on the mother's, enabling the baby to work with the milk flow, not against it.) Another suggestion is to try gentle compression on the breast that your baby is nursing on, so that some of the hind milk gets to the baby

On the opposite side of overactive let-down is, of course, underactive or slow let-down.

It is a main belief that some of the causes of underactive let-down and decreased milk production are stress, fatigue, and diet. However, that is not the case. Sometimes decreased milk production and slow let-down is influenced by placental fragments still left inside the uterus. Other causes include smoking, medication, breast surgery, and pregnancy after the third month. If your baby is frustrated during a feeding, showing signs of fussiness when offered the breast, or is slowly gaining weight, you may have underactive let-down.

A mother can do several things to encourage faster milk let-down. Have your partner massage you and/or lovingly talk to you while you are nursing. This helps release oxytocin, which is conducive to milk flow. You can also touch and sing to your baby to help produce oxytocin. Visualizations of waterfalls and milk flowing can help as well. If your milk supply does not increase after trying these things, consult a physician to check for any placental fragments or medication changes.

Milk let-down issues can be easily resolved; don't let your milk let-down let you down!

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Overactive and Underactive Let-Down

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25 comments

  1. Dawn says:

    If you think or feel like your supply might be low, consult with a breastfeeding specialist for help. I’m not loving all the breastfeeding information on this page, while I think this article is sufficient, so many others aren’t providing thorough enough or accurate information.

    Most hospitals have breastfeeding specialists you can talk to even after your discharged, some Peds clinics have lactation consultants that work in the clinic, there are Breastfeeding USA or La Leche League leaders that are available for free to help in many areas. WIC often has peer lactation counselors as well.

  2. Kasandra says:

    Always been overactive with both my boys

  3. Niki says:

    how long does it take for your milk to fully back whenever your mild production has slowed down, since 6 am this morning I have noticed a small change in the fullness of my breast but nothing like it has been these 5 months offul breastfeeding. any suggestions would be great.
    I feel like a bad mother or like s something im doing thatis making my milk slow down, ive had no problems up until last night and today?

  4. I had the overactive problem with my first.

  5. Donna says:

    I was forced to stop breastfeeding when baby is six weeks old. And he was fussy on my breast because he likes his milk to be fast flowing. So mine is what the so-called “underactive let-down” however I used the Back to the Breast Method. After five weeks of not breastfeeding I really decided to go back. latched on my baby after having a small bottle of formula and these were the times that he was sleepy. To my surprise he did feed and he would latched on for two hours and then having a long period of sleep after. I also thought that I won’t be able to breastfeed. Mother’s Milk Tea did not even help me and I just felt dizzy after drinking it. My baby is now six months old. However he is now starting to eat solids so he gradually cuts down on milk.

  6. Ashleigh says:

    My son is in the NICU so I only pump for now and my supply ismincredible, but i have been sleeping through the night because I am so tired. I am worried I will dry up from not pumping at night but I just cant wake up. Is this a legitimate worry?

  7. Sara says:

    with my other 2, I stopped producing entirely 🙁 im scared that will happen again. I really want to experience breast feeding my baby and that special bond

  8. Khalil says:

    I am having the not producing enough milk problem. I am trying Fenugreek and Mothers Milk. It helps but I am still not producing what I use to, any suggestions?

    • Hayley says:

      i had the same issue when i started back at work one thing i do when im home with my daughter is that as soon as she done eating i will pump from the same breast right afterwards its help a lot it has tricked my body into thinking that my daughter isnt done so its producing more for her also another thing is that staying hydrated really does help

    • Fenugreek and Mothers Milk are both worth trying. Are you pumping? Many women who breastfeed think that their supply has gone down because their breasts are softer and their baby is nursing faster, but that often simply means that your supply has regulated so that you are making just what your baby needs. If there is an issue with undersupply, nursing frequently and even power pumping can help to get you back on track.

  9. Kendra says:

    I don’t feel I have an overabundant supply, but I spray every time my son nurses. It’s frustrating for both of us, especially since he’s getting distractible while nursing and every time he pulls away to look at something, he gets a face-full!

  10. Flo says:

    Wow, I had no idea that breastfeeding could be so complicated.. I am praying that God will take care of this so that my little man and I won’t have any problems.

  11. For my first child he most certainly did not want the breast, I at first thought it was me but I read some babies just don’t latch on correctly or the mothers milk doesnt come quick enough, my son was always fussy and actually wanted the bottle preferably! Im hoping this child would be more excepting to being breast fed.

  12. Christina says:

    I wish I could get my let doen to work better when I pump, I have an over active one when my son nurses but a slow one when I pump, I try to visualize my son, and how great breastfeeding is for him, but sometimes it doesn’t help…. thank you for the info

  13. Miriam says:

    I constantly visualized milk flow while pumping at work. I wish it was more effective.

  14. Charlene says:

    At first I would get a little milk from the left and none from the right. Now I just get little drops from both. My baby is in the NICU and I have been pumping for him and it makes me feel very sad.

  15. AspenXIzzard says:

    I did too. I really wanted to the first time. This time I will do better.

  16. MrsPearson says:

    I lost my supply with my first child i really am trying to breastfeed this time i hope that everything goes well

  17. Suzannejan says:

    Currently I am pumping & feeding until we learn proper latch. My lactation consultant said since I already have an abundant supply, I should try to wean myself off of pumping a bit, from every few hours to eventually just once or twice a day.

  18. I have overactive let down in my left breast, and very underactive let down in my right, so I am constantly lopsided, and my baby is fussy with either side 🙁

  19. Jeanetta says:

    I’m worried about all of the above…

  20. ChrisS says:

    This very interesting. Good to know.

  21. TF11109 says:

    very helpful info

  22. Doodlebugg says:

    Down, and finding it hard to cope with an overactive let down. I absolutely don’t want to give up on breast feeding for my baby and the feeling of being a failure, but I feel like a bad mother when I dread feedings because of the pain and problems. Breast feeding is about bonding and joyfulness for both mother and baby. But me and baby have experienced neither just one problem after another.

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